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Student Council

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The CYC Summer Program is a week long volunteer program of Credit Valley Conservation for high school aged youth living or going to school in the Credit River watershed area. 2. CYC agrees to provide evidence of a student’s volunteer participation for their community involvement hours requirement for high school graduation or for any other request for verification of volunteer hours upon the completion of their time with us (i.e.: we sign your form at the end of the week). 3. Credit Valley Conservation will not pay a salary or hourly wage to CYC participants. 4. CYC week long programs offer up to 35 hours volunteer time to high school students. Credit for additional hours can be obtained from CVC by participating in other CVC run volunteer events.

5. CYC will provide transportation to and from the assigned meeting place and all CYC work or activity sites only. 6. Transportation to and from the designated meeting place each morning will be the participants’ responsibility. 7. Volunteer contributions accumulate each day once a participant is picked up by the CYC Crew Leader in the morning at the assigned meeting place and stop once returned to the meeting place at the end of the day. 8. Only actual volunteered time will be reflected in our records and on any document CVC provides as evidence of volunteered time. For civic holidays, cancellation of a day’s activities, or for any reason a participant has missed a day, volunteer hours will not be calculated.

9. Each day volunteers will be given a break for lunch and routine breaks in both the morning and afternoon. 10. Participants will be supervised by CYC Crew Leaders and CVC staff. 11. Participants shall return any equipment or supplies provided to them unless otherwise stated. 12. Participants for the week are expected to be present on the first day of each new week for health and safety orientation, code of conduct information and other relevant
training or preparation. 13. Continued participation in CYC is dependant upon adherence to all rules, safety guidelines and any instructions as given by CVC staff including CYC’s Code of Conduct as found on our website www.creditvalleyca.ca/cyc. 14. In the event that a health and safety policy or safety standard is being or is about to be violated, or if a person is in any jeopardy, immediate action will be taken by the site supervisor in charge to restore and/or maintain safety at all times.

This may result in some of the following actions but not limited to: the cancellation of or alteration to a CYC activity, the removal of any number of individuals from the activity or the program, or refusal to permit an individual(s) from participating in an activity on the grounds that it may constitute a safety policy violation or failure to meet a safety standard.

15. Participants must report all injuries, no matter how slight, to their supervisor. 16. CVC reserves the right to terminate this program or the placement status of any participant at any time for failure to comply with these terms and conditions.

Name of Participant:__________________________ Participant’s Signature:________________________ Name of Parent: ______________________________Name of Witness:_____________________________ Parent’s Signature: ____________________________Witness’ Signature:___________________________ Date: ________________________

INFORMED CONSENT, MEDICAL, PHOTOGRAPHIC RELEASE & GENERAL PERMISSION, Parents, Guardians, and participants over age 18 please carefully read the paragraphs below and provide your signatures in the spaces provided demonstrating that you have read and understood them. IF YOU HAVE ANY QUESTIONS REGARDING THE FOLLOWING MATERIAL CALL THE PHONE NUMBER GIVEN AT THE END OF THIS APPLICATION FORM.

INFORMED CONSENT & ELEMENTS OF RISK
Certain RISKS OF INJURY, DANGERS and HAZARDS are inherent to participation in this Activity. The dangers and hazards include but are not limited to: falling on or over steep, uneven, slippery or jagged ground, walking where branches, rocks, roots, fences or other obstacles or hazards may cause a person to trip or fall, walking through or beside streams, creeks, rivers, ponds and lakes, injury from tools like shovels, hammers or other hand tools, sudden extreme weather conditions, encounters with wildlife, interaction with vehicle traffic and miscellaneous health problems related to over-exposure to the sun, insect bites, fatigue and exertion. These dangers and hazards can be beyond the control of CVC and may result from the Participant’s actions or inactions, or the actions or inactions of others including CVC, or a combination of all the aforementioned. The chance of an injury occurring can be reduced by carefully following instructions at all times while engaged in the Activity.

If you choose to participate in the Activity, as previously described, you must understand that you bear the responsibility for any injury that may occur.
ACKNOWLEDGMENT OF RISK
I/We have read the above. I/We understand that in participating in the previously described Activity, I/we are assuming the risks associated with doing so.
Name of Participant:__________________________ Participant’s Signature:________________________ Name of Parent: _________________________Name of Witness:__________________________ Parent’s Signature: _______________________Witness’ Signature:________________________ Date: ________________________

MEDICAL TREATMENT
I/ We consent for the Participant, in the event of injury or illness while under the supervision of the Credit Valley Conservation (CVC), to receive first aid and/or any further medical attention that potentially may be required to the extent determined by, and at the discretion of CVC staff, emergency medical services, and licensed medical professionals.

Name of Participant:__________________________ Participant’s
Signature:________________________ Name of Parent: _________________________Name of Witness:___________________________ Parent’s Signature: _______________________Witness’ Signature:________________________ Date: ________________________

PHOTOGRAPHIC RELEASE
[To be read and signed by all Participants and by Parents of Participants under the age of 18 years] I/We agree to grant permission for images of the Participant captured during the activity through use of video, photo and digital camera, to be used by CVC for promotional purposes including internet, social marketing media, printed materials and appearance in local news media and do hereby waive any rights of compensation or ownership.

Name of Participant:__________________________ Participant’s Signature:________________________ Name of Parent: _________________________Name of Witness:_________________________ Parent’s Signature: _______________________Witness’ Signature:________________________ Date: ________________________

GENERAL PERMISSION
I give ____________________________permission to participate in the Activity as previously described. (print name of Participant)

Name of Participant:__________________________ Participant’s Signature:________________________ Name of Parent: _________________________Name of Witness:___________________________ Parent’s Signature: _______________________Witness’ Signature:________________________ Date: ________________________

Application Check List:
On-line Applications:
Is all required information entered?
A parent or guardian has read and understood the TERMS AND CONDITIONS and
INFORMED CONSENT, MEDICAL, PHOTOGRAPHIC RELEASE & GENERAL PERMISSION?
These pages have been signed by a parent or guardian (or by the participant if they are over the age of 18) These pages are ready to be mailed, emailed or faxed to CVC within one week of completing the on-line application. (They must be submitted in order for application to be deemed complete. Remember that incomplete applications will not be considered for placement). You are able to receive emails from [email protected] in order to receive confirmation of acceptance to program. You will have to respond to this email to confirm attendance. Ensure emails from us will not go into your junk folder.

PLEASE MAIL OR FAX THIS RELEASE TO THE INFORMATION BELOW:
ATTN: Conservation Youth Corps, Credit Valley Conservation
1255 Old Derry Road, Mississauga, ON, L5N 6R4 Fax: 905-670-2210 Phone: 905-670-1615 For more information or to apply on-line visit www.creditvalleyca.ca/cyc

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